How much rates vary
Facilitymedian $3,162 · 10th to 90th $661 to $7,413Professionalmedian $245 · 10th to 90th $178 to $550
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $295.12 Median $3,548.13 Typical High $7,762.47 | Facility | None | $295.12 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $467.74 | Professional | None | $177.83 | $275.42 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $501.19 | Professional | None | $208.93 | $245.47 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $363.08 Typical High $741.31 | Professional | 50 · Both sides | $309.03 | $363.08 | $741.31 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $354.81 | Professional | None | $234.42 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,884.03 | Facility | None | $912.01 | $1,445.44 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $933.25 | Professional | None | $128.82 | $208.93 | $933.25 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $588.84 | Facility | None | $169.82 | $229.09 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $537.03 | Professional | None | $302.00 | $331.13 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $323.59 | Professional | None | $173.78 | $251.19 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,949.84 Typical High $2,884.03 | Facility | None | $489.78 | $1,949.84 | $2,884.03 |
MVP Health Care Setting Facility Modifier None Typical Low $208.93 Median $1,819.70 Typical High $8,511.38 | Facility | None | $208.93 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $616.60 | Professional | None | $295.12 | $295.12 | $616.60 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $630.96 | Professional | None | $131.83 | $234.42 | $630.96 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $229.09 Typical High $912.01 | Facility | None | $123.03 | $229.09 | $912.01 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $323.59 | Professional | None | $173.78 | $251.19 | $323.59 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $89.13 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $204.17 Typical High $223.87 | Professional | 54 · Surgery only | $134.90 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $27.54 | $30.20 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $251.19 | Professional | 53 · Discontinued | $125.89 | $165.96 | $251.19 |
Where New York sits
The same service costs 3.1 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 51st of 51
$257
AK $794NY $257
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.